Calcium deficiency at the global, national, and individual levels

Calcium deficiency at the global, national, and individual levels

This Thought for Food is part of a series on key nutrients identified as global challenges by the SNi DELTA Model®.

Calcium is an essential dietary nutrient: a trace element that is vital for healthy bodily function. However, a recent report composed by the Calcium Task Force (created by New York Academy of Sciences in partnership with the Children’s Investment Fund Foundation) has identified widespread global calcium deficiency. This matches results of the DELTA Model®, which show that global calcium availability from food is only around two-thirds of the global population’s requirement. Here we provide a closer look at the role of dietary calcium, levels of deficiency, and ways forward to improve intakes.

The Task Force was composed of scientists with expertise in nutrition, particularly around micronutrients and child health. Their report aimed to gather the existing data on calcium deficiency and associated health outcomes to assist policy and dietary interventions to reduce the prevalence of deficiency.

Calcium intakes

About 99% of calcium in the body is in our bones. The rest plays a host of roles in our muscular, hormone and nervous system function, as well as in normal cell function. Calcium has a key skeletal role; therefore, calcium intake is particularly important in childhood and adolescence during bone growth. For all of these functions, calcium becomes important again in later life, such as during pregnancy and for bone retention in older adults.

Dietary calcium requirements are set largely based on bone health outcomes; that is, the intakes of people who have healthy bones are deemed sufficient intakes. This is due to the difficulty of understanding exactly how much calcium a person needs each day. When calcium intake is insufficient to meet bodily requirements, calcium stored in bone is used to maintain the other bodily functions requiring calcium, so no immediate effects are obvious. However, a sustained deficient calcium intake over a long period will to lead to depletion of bone calcium stores.

Another challenge in setting recommended intakes is the role of diet. Food sources of calcium, as well as what else is being eaten at the time of calcium ingestion, impacts calcium bioavailability. Plant antinutrients, such as phytic and oxalic acid, can bind to calcium and make it less easily absorbed by the gut. Vitamin D (another dietary micronutrient) is essential for active calcium absorption, and low vitamin D can increase bone calcium turnover and calcium requirement.

As a result of these challenges, there is variation in recommended intakes depending on which authority you ask: for example, the recommended intake range for infants in the Unites States and Canada is around double that recommended in the United Kingdom. Recommended intakes change as you age, and there is less variation in recommendations for adults – around 800 mg per day for most authorities.

Using the DELTA Model® Nutrient Supply and Density tools, the richest sources of calcium per unit mass are various oilcrops, spices and aquatic plants, all of which make minor contributions to global dietary calcium (<25 mg per person per day). The largest contributor to global calcium availability is dairy, accounting for 49% of global food calcium, or around 300 mg per capita per day. Next are vegetables, at around 100 mg per capita per day, cereals at around 50, and meat at around 25.

Calcium
Global sources of calcium in 2018 from the DELTA Model® Nutrient Supply tool.

Calcium deficiency

The Task Force report stated that around 3.5 billion people worldwide are at risk of inadequate calcium intake, with the vast majority of these individuals located in Africa and Asia. Calcium deficiency is more widespread in low- and middle-income countries than in high-income nations. For those countries where data is available, it is children, adolescents, and individuals over 50 who are most commonly deficient, with women more likely to be affected than men.

We used the DELTA Model® approach to compare 2018 national nutrient availability data for demographically weighted national calcium requirements. We found that only 33 out of 170 countries had sufficient calcium availability to meet the needs of their populations. This sufficiency ranged from just enough to a 90% calcium surplus in Finland. Most of these countries were in Europe, with a few from Western Asia, as well as the US and Australia.

We found the lowest calcium availability compared to requirement in lower income countries in Africa, the Caribbean and Southeast Asia. In some cases, as little as 16% of population calcium requirement was nationally available (Timor-Leste). While data quality is often poorer for these regions compared to Europe and North America, 77 out of 170 countries had less than half of their calcium requirements available, thus these calculations echo the results found by the Task Force.

Health outcomes

The greatest focus of studies on the health outcomes of calcium deficiency relate to bone health.

Osteoporosis (brittle bones) is linked to extended low calcium intake and increases the risk that bones will break under stress. Osteoporosis disproportionately affects women, particularly over the age of 50. Calcium and vitamin D supplementation have been shown to reduce fracture rates in older people in some clinical trials, but this affect is not always observed. Rickets is a similar condition mostly observed in children and linked to low calcium and/or vitamin D intakes.

Interestingly, despite the fact that lower income countries tend to have lower calcium intakes, they also have lower rates of bone fracture than high intake countries. However, the report authors caution that these lower income countries have poorer quality health data and smaller elderly populations, among other confounding factors. Studies on bone mineral density and fracture risk often show contrasting results between and even within regions. Furthermore, many regions lack data on bone health, making causative associations difficult.

In lower income parts of the world, the impacts of low calcium intake are often overshadowed by shorter-term outcomes of malnutrition, such as anaemia, wasting and stunting, as well as infectious diseases. Of current interest is the potential role of calcium intake in pregnancy disorders of hypertension and related mortalities.

Other research has investigated relationships between calcium intake or supplementation and a broader variety of health outcomes, such as cardiovascular disease, colorectal cancer, and kidney stones, with varied and sometimes contradictory outcomes. Dosage and target population appear to play a role, but there remains much to be understood about the role of calcium in health.

Evidence is mixed on the role of calcium supplementation in various health outcomes, although large health organisations state that intakes within the recommended boundaries should carry no health risk for most populations. Table reproduced from Li et al. 2018

Increasing calcium availability and consumption

While there is still a lack of consensus on the exact calcium intakes necessary for consumption, the number of individuals globally not meeting even the most conservative recommendations merits intervention.

Calcium supplementation is widespread in high-income nations: more than half of US women over the age of 60 received supplements in the early 2000s. Supplementary calcium is absorbed at a similar rate to dietary calcium, but the latter has been shown to have more of an impact on bone health, likely due to the smaller but more frequent intake of calcium in food than in a single supplement dose. Some studies have reported adverse effects of (particularly high) calcium supplementation related to various health outcomes, but the position of large health organisations is that intakes within the boundaries of dietary recommendations should have no adverse effects.

From a food perspective, those countries with the lowest calcium intakes are most commonly those with low dairy intakes. High European dairy consumption matches our results that these countries had the highest 2018 calcium availability. Increasing the consumption of calcium dense foods, such as dairy, nuts, seeds, and whole fish will not only improve calcium intakes, but also the intakes of other essential nutrients, due to the nutrient dense nature of these foods.

Conclusion

The final recommendations of the Task Force report for future work were: to progress towards consensus on the true global prevalence of calcium deficiency; to obtain more data on global calcium intakes, particularly in lower-income, higher-risk countries; and, to clarify the role of calcium in fracture risk and bone mineral density. The authors also noted the challenging absence of some method to determine the calcium status of an individual, given there is currently no single biomarker or health outcome that does so.

What can be said incontrovertibly is that deficient calcium intakes are common worldwide. While the full extent and impact of this deficiency is uncertain, that should not prevent action to improve intakes toward recommended levels.

The SNi team thank Professor Connie Weaver, expert in mineral bioavailability and the role of calcium in human nutrition, for her contributions to this Thought for Food. Prof Weaver was an author on the Task Force report.



Professor Warren McNabb
Warren McNabb is a Professor of Nutritional Science at the Riddet Institute; one of New Zealand’s Centres of Research Excellence (CoRE), hosted by Massey University. He leads SNi® and his research interests include digestive physiology and metabolism, nutrition for health, and sustainable nutrition.
Project Leader | W.McNabb@massey.ac.nz
Professor Warren McNabb
Warren McNabb is a Professor of Nutritional Science at the Riddet Institute; one of New Zealand’s Centres of Research Excellence (CoRE), hosted by Massey University. He leads SNi® and his research interests include digestive physiology and metabolism, nutrition for health, and sustainable nutrition.
Project Leader | W.McNabb@massey.ac.nz
Dr Nick Smith
Nick works as a mathematical modeller on the Riddet Institute SNi®. He is responsible for a wide range of SNi's work and the continued development of the SNi models like the DELTA Model®. This is a tool for investigating how global food production meets global nutritional requirements as part of a sustainable food system.
Research Officer
Dr Nick Smith
Nick works as a mathematical modeller on the Riddet Institute SNi®. He is responsible for a wide range of SNi's work and the continued development of the SNi models like the DELTA Model®. This is a tool for investigating how global food production meets global nutritional requirements as part of a sustainable food system.
Research Officer
Dr Andrew Fletcher
Andrew is a Chemical Engineer with a PhD in process control and modelling. Andrew is a Honorary Fellow at the Riddet Institute and has been involved with SNi® since the outset. He is based at the Fonterra Research and Development Centre in Palmerston North and is involved in a range of research, management and strategy roles.
Honorary Fellow
Dr Andrew Fletcher
Andrew is a Chemical Engineer with a PhD in process control and modelling. Andrew is a Honorary Fellow at the Riddet Institute and has been involved with SNi® since the outset. He is based at the Fonterra Research and Development Centre in Palmerston North and is involved in a range of research, management and strategy roles.
Honorary Fellow
Professor Jeremy Hill
Professor Jeremy Hill has played a major role in developing SNi®. He has also been involved in developing strategic partnerships between Fonterra and the Riddet Institute. For example, the establishment of three Professorial Chairs in Food Material Science, Nutrition, and Consumer and Sensory Science. Jeremy is the Chief Science and Technology Officer at Fonterra.
Adjunct Professor
Professor Jeremy Hill
Professor Jeremy Hill has played a major role in developing SNi®. He has also been involved in developing strategic partnerships between Fonterra and the Riddet Institute. For example, the establishment of three Professorial Chairs in Food Material Science, Nutrition, and Consumer and Sensory Science. Jeremy is the Chief Science and Technology Officer at Fonterra.
Adjunct Professor
Dr Mahya Tavan
Mahya is a postdoctoral research fellow working on the development of the iOTA model. iOTA is a dietary optimisation tool for designing sustainable diets that are nutritious, acceptable and affordable. Prior to joining SNi®, Mahya held a research role at the University of Melbourne, Australia where she carried out various research projects on sustainable food production, resource use efficiency and biofortification of fresh food.
Postdoctoral Research Fellow
Dr Mahya Tavan
Mahya is a postdoctoral research fellow working on the development of the iOTA model. iOTA is a dietary optimisation tool for designing sustainable diets that are nutritious, acceptable and affordable. Prior to joining SNi®, Mahya held a research role at the University of Melbourne, Australia where she carried out various research projects on sustainable food production, resource use efficiency and biofortification of fresh food.
Postdoctoral Research Fellow
Raquel Lozano
Raquel is a postdoctoral research fellow creating models for national food systems. Her PhD research focused on helping design horticultural packaging systems to minimise the environmental impact. Raquel was awarded the International Society of Horticultural Sciences Young Minds Award in 2023, and is keen to use mathematical modelling to provide holistic information to decision-makers in the area of sustainable nutrition.
Postdoctoral Research Fellow
Raquel Lozano
Raquel is a Postdoctoral Research Fellow creating models for national food systems. Her PhD research focused on helping design horticultural packaging systems to minimise the environmental impact. Raquel was awarded the International Society of Horticultural Sciences Young Minds Award in 2023, and is keen to use mathematical modelling to provide holistic information to decision-makers in the area of sustainable nutrition.
Postdoctoral Research Fellow
Patricia Soh
Prior to her current PhD, Patricia attained a Master of Science in Human Nutrition at Massey University, Albany. The current focus of her PhD is investigating nutritional concerns within vegan diets.
PhD Student
Patricia Soh
Prior to her current PhD, Patricia attained a Master of Science in Human Nutrition at Massey University, Albany. The current focus of her PhD is investigating nutritional concerns within vegan diets.
PhD Student
Ejovi Abafe
Prior to his current PhD, Ejovi obtained a Master’s and a Bachelor’s degree in Agricultural Economics from the University of South Africa (UNISA) and Delta State University, Nigeria. The current focus of his PhD at the Riddet Institute is Global land use for the delivery of nutrition.
PhD Student
Ejovi Abafe
Prior to his current PhD, Ejovi obtained a Master’s and a Bachelor’s degree in Agricultural Economics from the University of South Africa (UNISA) and Delta State University, Nigeria. The current focus of his PhD at the Riddet Institute is Global land use for the delivery of nutrition.
PhD Student
Justine Coomson
Prior to her current PhD, Justine obtained a Masters degree in Population, Family and Reproductive Health and a Bachelor's degree in Dietetics from the University of Ghana. Justine has worked as a research assistant and a clinical dietician in Ghana before coming to New Zealand. The current focus on her PhD is the impact of biofortification and supplementation to diets.
PhD Student
Justine Coomson
Prior to her current PhD, Justine obtained a Masters degree in Population, Family and Reproductive Health and a Bachelor's degree in Dietetics from the University of Ghana. Justine has worked as a research assistant and a clinical dietician in Ghana before coming to New Zealand. The current focus on her PhD is the impact of biofortification and supplementation to diets.
PhD Student
Hannah Ramsay
Hannah is the Project Manager for SNi®. She started her career in the Riddet Institute when she first came to New Zealand and has since done project and event work across various educational institutes. The opportunity to return to Project Management at the Riddet Institute was very welcome, especially given the fascinating research and mahi conducted as part of SNi®.
Project Manager | H.Ramsay@massey.ac.nz
Hannah Ramsay
Hannah is the Project Manager for SNi®. She started her career in the Riddet Institute when she first came to New Zealand and has since done project and event work across various educational institutes. The opportunity to return to Project Management at the Riddet Institute was very welcome, especially given the fascinating research and mahi conducted as part of SNi®.
Project Manager | H.Ramsay@massey.ac.nz
Dr Amelia Barker
Amelia is a Communications Officer at the Riddet Institute. She has many years experience in digital media communications at various organisations. Amelia is passionate about research and enjoys promoting the fantastic mahi (work) that SNi® does.
Communications Officer
Amelia Barker
Amelia is a Communications Officer at the Riddet Institute. She has many years experience in digital media communications at various organisations. Amelia is passionate about research and enjoys promoting the fantastic mahi (work) that SNi® does.
Communications Officer
Rangimarie Hunia
Rangimarie Hunia was appointed an alternate director of Te Ohu Kaimoana at the beginning of 2015 before being appointed a full director in November 2015, and Chair in July 2019. The first wahine (woman) Chair in the history of Te Ohu Kaimoana. In 2017, she was appointed a Chair of Te Pūtea Whakatupu Trust. In 2016, she was appointed Chief Executive of Ngāti Whātua Ōrakei Whai Maia. Whai Maia is responsible for the well-being of its 5,000 tribal members and focuses on education, health, employment and environmental areas. She played an active role as a member of the Iwi Working Group that was established to facilitate understanding and iwi decision making in response to the 11-year Review of Māori Fisheries Settlement entities. Rangimarie is also a member of Global Women and was a finalist in the Westpac Women of Influence Awards 2014.
Ngāti Whātua Chair of the SNi® International Advisory Group Chief Executive of Ngāti Whātua Ōrakei Whai Maia
Rangimarie Hunia
Rangimarie Hunia was appointed an alternate director of Te Ohu Kaimoana at the beginning of 2015 before being appointed a full director in November 2015, and Chair in July 2019. The first wahine (woman) Chair in the history of Te Ohu Kaimoana. In 2017, she was appointed a Chair of Te Pūtea Whakatupu Trust. In 2016, she was appointed Chief Executive of Ngāti Whātua Ōrakei Whai Maia. Whai Maia is responsible for the well-being of its 5,000 tribal members and focuses on education, health, employment and environmental areas. She played an active role as a member of the Iwi Working Group that was established to facilitate understanding and iwi decision making in response to the 11-year Review of Māori Fisheries Settlement entities. Rangimarie is also a member of Global Women and was a finalist in the Westpac Women of Influence Awards 2014.
Ngāti Whātua Chair of SNi® International Advisory Group Chief Executive of Ngāti Whātua Ōrakei Whai Maia
Jeroen Dijkman
Dr. Jeroen Dijkman is the founding head of the Nestlé Institute of Agricultural Sciences at Nestlé Research. The Institute aims to translate novel agricultural science into concrete applications and to identify and develop the most promising regenerative agriculture technologies. Headquartered in Lausanne, Switzerland, the organization has a decentralized structure and incorporates Nestlé’s existing plant sciences research facilities in France, as well as numerous research and reference farms around the world. The Institute has three focus areas: plant sciences, dairy-livestock sciences and agricultural system sciences. Jeroen has worked for over 30 years, in all major regions of the world, with bi- and multi-lateral donors, i-NGOs, international and national research centres, the World Bank, UN agencies and the private sector on finding ways to use research and innovation to transition agri-food systems towards more productive but also more sustainable and socially inclusive pathways. In his last two assignments prior to taking up his current position, Jeroen combined the roles of Director (International) of the New Zealand Agricultural Greenhouse Gas Research Centre and the Senior Technical Adviser of the UN Environment, Climate and Clean Air Coalition agriculture initiative. Subsequently, he was the Managing Director of the Animal Sciences Group, Wageningen University and Research. The Animal Sciences Group consists of the Department of Animal Sciences of Wageningen University and three Wageningen Research institutes: Wageningen Bio-veterinary Research, Wageningen Livestock Research and Wageningen Marine Research.
Head of Nestlé Institute of Agricultural Sciences
Jeroen Dijkman
Dr. Jeroen Dijkman is the founding head of the Nestlé Institute of Agricultural Sciences at Nestlé Research. The Institute aims to translate novel agricultural science into concrete applications and to identify and develop the most promising regenerative agriculture technologies. Headquartered in Lausanne, Switzerland, the organization has a decentralized structure and incorporates Nestlé’s existing plant sciences research facilities in France, as well as numerous research and reference farms around the world. The Institute has three focus areas: plant sciences, dairy-livestock sciences and agricultural system sciences. Jeroen has worked for over 30 years, in all major regions of the world, with bi- and multi-lateral donors, i-NGOs, international and national research centres, the World Bank, UN agencies and the private sector on finding ways to use research and innovation to transition agri-food systems towards more productive but also more sustainable and socially inclusive pathways. In his last two assignments prior to taking up his current position, Jeroen combined the roles of Director (International) of the New Zealand Agricultural Greenhouse Gas Research Centre and the Senior Technical Adviser of the UN Environment, Climate and Clean Air Coalition agriculture initiative. Subsequently, he was the Managing Director of the Animal Sciences Group, Wageningen University and Research. The Animal Sciences Group consists of the Department of Animal Sciences of Wageningen University and three Wageningen Research institutes: Wageningen Bio-veterinary Research, Wageningen Livestock Research and Wageningen Marine Research.
Head of Nestlé Institute of Agricultural Sciences
Berry Marttin
Berry Marttin was born and raised in Brazil. Over the course of his career at Rabobank, he gained extensive experience as an international banker in both wholesale and retail banking, working in various senior executive positions in Australia, Indonesia, Hong Kong, Curacao and Brazil. Mr Marttin moved to the Netherlands in 2004 to become Chairman of the Board of Directors of Rabobank Amsterdam. In 2009, he joined the Managing Board with special focus on Rabobank’s international Wholesale and Rural banking activities and further responsibilities including Leasing (DLL), Rabo Carbon Bank and RaboResearch. His principal other activities outside Rabobank include serving as President of the EACB (European Association of Co-operative Banks) and Member of the Board of Neumann Foundation. Moreover, Mr Marttin serves as the first Chairman of the Global Steering Committee of the Food Action Alliance, where World Economic Forum together with IFAD, WBCSD, CIAT, AfDB and Rabobank and over 20 global leaders unite to deploy large scale action through game changing initiatives for food systems transformation. In 2021, he was invited to join the UN Food Systems Summit Champions network, a network encompassing leadership from a broad range of constituencies, in all parts of the world, who are championing food systems and food systems transformation.
Former Member of the Managing Board Rabobank Group
Berry Marttin
Berry Marttin was born and raised in Brazil. Over the course of his career at Rabobank, he has gained extensive experience as an international banker in both wholesale and retail banking, working in various senior executive positions in Australia, Indonesia, Hong Kong, Curacao and Brazil. Mr Marttin moved to the Netherlands in 2004 to become Chairman of the Board of Directors of Rabobank Amsterdam. In 2009, he joined the Managing Board with special focus on Rabobank’s international Wholesale and Rural banking activities and further responsibilities including Leasing (DLL), Rabo Carbon Bank and RaboResearch. His principal other activities outside Rabobank include serving as President of the EACB (European Association of Co-operative Banks) and Member of the Board of Neumann Foundation. Moreover, Mr Marttin serves as the first Chairman of the Global Steering Committee of the Food Action Alliance, where World Economic Forum together with IFAD, WBCSD, CIAT, AfDB and Rabobank and over 20 global leaders unite to deploy large scale action through game changing initiatives for food systems transformation. In 2021, he was invited to join the UN Food Systems Summit Champions network, a network encompassing leadership from a broad range of constituencies, in all parts of the world, who are championing food systems and food systems transformation.
Member of the Managing Board Rabobank Group
Dr Jason Clay
Jason Clay is the Senior Vice President for Markets and Executive Director of the Markets Institute at WWF, which was created to identify and address emerging global issues, trends, and tools impacting conservation in more timely, cost-effective, and scalable ways. His career has ranged from working on a family farm and for the US Department of Agriculture. He taught at Harvard and Yale and spent more than 35 years with human rights and environmental NGOs. In 1988, Clay founded Rainforest Marketing, set up a trading company within an NGO, helped Indigenous people and local communities access global markets, and launched Ben & Jerry’s Rainforest Crunch, plus more than 200 other products with sales of $100 million. From 1999 to 2003, he co-directed a WWF, the World Bank, UN FAO, and NACA consortium to identify the most significant environmental and social impacts of shrimp aquaculture, as well as practices to reduce them. From 2004 to 2012, he convened multistakeholder roundtables to create performance-based standards for commodities including salmon, soy, sugarcane, cotton, and beef. He developed WWF’s Market Transformation program in 2006 to work on agriculture, aquaculture, livestock, and corporate engagement. Clay continues to lead WWF-US efforts to improve private sector supply chain management and help their producers address the most significant impacts. In 2008, he created the Carbon and Commodities program to address supply chain GHG emissions. He has helped whole sectors improve their sustainability performance (e.g., the Global Salmon Initiative). He is now working with the global leather industry to support a DCF leather fund and is testing support for a 1% environmental performance payments to support the transition costs and incentives to finance what producers need to do to become legal and deforestation and conversion free. He is launching a two-year proof of concept for Codex Planetarius, a set of minimum global standards to reduce the key impacts of food and commodities traded internationally. Clay has authored 18 books and 500 articles, and has given more than 1,500 invited presentations. He studied anthropology and agriculture at Harvard, the London School of Economics, and Cornell (PhD).
Senior Vice President, Markets at World Wildlife Fund (WWF)
Dr Jason Clay
Jason Clay is the Senior Vice President for Markets and Executive Director of the Markets Institute at WWF, which was created to identify and address emerging global issues, trends, and tools impacting conservation in more timely, cost-effective, and scalable ways. His career has ranged from working on a family farm and for the US Department of Agriculture. He taught at Harvard and Yale and spent more than 35 years with human rights and environmental NGOs. In 1988, Clay founded Rainforest Marketing, set up a trading company within an NGO, helped Indigenous people and local communities access global markets, and launched Ben & Jerry’s Rainforest Crunch, plus more than 200 other products with sales of $100 million. From 1999 to 2003, he co-directed a WWF, the World Bank, UN FAO, and NACA consortium to identify the most significant environmental and social impacts of shrimp aquaculture, as well as practices to reduce them. From 2004 to 2012, he convened multistakeholder roundtables to create performance-based standards for commodities including salmon, soy, sugarcane, cotton, and beef. He developed WWF’s Market Transformation program in 2006 to work on agriculture, aquaculture, livestock, and corporate engagement. Clay continues to lead WWF-US efforts to improve private sector supply chain management and help their producers address the most significant impacts. In 2008, he created the Carbon and Commodities program to address supply chain GHG emissions. He has helped whole sectors improve their sustainability performance (e.g., the Global Salmon Initiative). He is now working with the global leather industry to support a DCF leather fund and is testing support for a 1% environmental performance payments to support the transition costs and incentives to finance what producers need to do to become legal and deforestation and conversion free. He is launching a two-year proof of concept for Codex Planetarius, a set of minimum global standards to reduce the key impacts of food and commodities traded internationally. Clay has authored 18 books and 500 articles, and has given more than 1,500 invited presentations. He studied anthropology and agriculture at Harvard, the London School of Economics, and Cornell (PhD).
Senior Vice President, Markets at World Wildlife Fund (WWF)
Professor Manny Noakes
Professor Manny Noakes has a PhD in nutrition as well as having trained as a dietitian in her earlier years. She is more recently a graduate of the Australian Institute of Company Directors. Prof Noakes is a former Director and Senior Principal Research Scientist, Nutrition and Health at CSIRO, Australia. She currently runs her own nutrition consultancy and is also a non-executive Director for Meat and Livestock Australia. She is considered a key opinion leader and advisor in nutrition and health, has extensive media and public speaking experience. She has over 25 years’ experience in many fields of nutrition and health, and has undertaken numerous clinical dietary intervention trials in weight management, functional foods and cardiovascular health. She has also undertaken research on diet and sustainability and redefined the environmental agenda from a food and health perspective. Prof Noakes has authored more than 200 peer-reviewed publications which have been cited more than 9000 times and has an H index of 52. She was instrumental in the development and release of five editions of the CSIRO Total Wellbeing Diet, which was launched in 2004 and has been translated into 17 languages and sold over one million copies in Australia. The Total Wellbeing Diet has been further commercialised to a successful online programme. Prof Noakes is the recipient of three CSIRO Medals, is a Distinguished Alumni of Flinders University, holds a research excellence award from the University of Adelaide and is a recipient of the Zonta Club Woman of International Achievement award.
Nutrition Consultant
Professor Manny Noakes
Professor Manny Noakes has a PhD in nutrition as well as having trained as a dietitian in her earlier years. She is more recently a graduate of the Australian Institute of Company Directors. Prof Noakes is a former Director and Senior Principal Research Scientist, Nutrition and Health at CSIRO, Australia. She currently runs her own nutrition consultancy and is also a non-executive Director for Meat and Livestock Australia. She is considered a key opinion leader and advisor in nutrition and health, has extensive media and public speaking experience. She has over 25 years’ experience in many fields of nutrition and health, and has undertaken numerous clinical dietary intervention trials in weight management, functional foods and cardiovascular health. She has also undertaken research on diet and sustainability and redefined the environmental agenda from a food and health perspective. Prof Noakes has authored more than 200 peer-reviewed publications which have been cited more than 9000 times and has an H index of 52. She was instrumental in the development and release of five editions of the CSIRO Total Wellbeing Diet, which was launched in 2004 and has been translated into 17 languages and sold over one million copies in Australia. The Total Wellbeing Diet has been further commercialised to a successful online programme. Prof Noakes is the recipient of three CSIRO Medals, is a Distinguished Alumni of Flinders University, holds a research excellence award from the University of Adelaide and is a recipient of the Zonta Club Woman of International Achievement award.
Nutrition Consultant
Lain Jager
Lain Jager is best known for his time with the hugely successful kiwifruit marketer Zespri where he was CEO from 2008 to 2017. During his tenure as CEO, Zespri grew strongly through the impact and recovery from the bacterial vine disease Psa, grower returns doubled, and the share price grew from $1.00 to $8.00. Today, Lain is involved in a range of investment projects in Tourism and Agribusiness, serves as a Director on several Boards, was the Chairman of the Primary Sector Council that produced the Fit for a Better World Report focused on the New Zealand Food and Fibre Sector, and is the Co-Chair of Te Puna Whakaaronui – a Food and Fibre think tank. Lain and his wife Debra live on a lifestyle block in Tauranga, New Zealand.
Chair of the Thought Leaders Group for Te Puna Whakaaronui Food and Fibre Think Tank
Lain Jager
Lain Jager is best known for his time with the hugely successful kiwifruit marketer Zespri where he was CEO from 2008 to 2017. During his tenure as CEO, Zespri grew strongly through the impact and recovery from the bacterial vine disease Psa, grower returns doubled, and the share price grew from $1.00 to $8.00. Today, Lain is involved in a range of investment projects in Tourism and Agribusiness, serves as a Director on several Boards, was the Chairman of the Primary Sector Council that produced the Fit for a Better World Report focused on the New Zealand Food and Fibre Sector, and is the Co-Chair of Te Puna Whakaaronui – a Food and Fibre think tank. Lain and his wife Debra live on a lifestyle block in Tauranga, New Zealand.
Chair of the Thought Leaders Group for Te Puna Whakaaronui Food and Fibre Think Tank
Samuel Thevasagayam
Samuel Thevasagayam is the Director of Livestock and Aquaculture within the Agriculture Development Program at the Bill & Melinda Gates Foundation, where he oversees the implementation of foundation’s strategy in animal health, animal production, animal nutrition, animal systems and livestock off-take markets in sub-Saharan Africa and South Asia. Samuel started his career as a small animal clinician and lecturer at the University of Peradeniya, Sri Lanka. He then moved to work in academic research, Pharmaceutical R&D (veterinary and human), Business Development and the not-for profit sector, living/working in four continents before joining the Gates Foundation in 2012. Samuel graduated from the faculty of Veterinary Medicine and Animal Sciences of the University of Peradeniya, Sri Lanka. Gained his PhD in veterinary virology from the University of Hertfordshire for his research on foot-and-mouth disease virus at the Pirbright Institute and holds an MBA from the University of Oxford. He is a Fellow of the Royal Society of Biology.
Director of Livestock and Aquaculture within the Agriculture Development Program, Bill & Melinda Gates Foundation
Samuel Thevasagayam
Samuel Thevasagayam is the Director of Livestock and Aquaculture within the Agriculture Development Program at the Bill & Melinda Gates Foundation, where he oversees the implementation of foundation’s strategy in animal health, animal production, animal nutrition, animal systems and livestock off-take markets in sub-Saharan Africa and South Asia. Samuel started his career as a small animal clinician and lecturer at the University of Peradeniya, Sri Lanka. He then moved to work in academic research, Pharmaceutical R&D (veterinary and human), Business Development and the not-for profit sector, living/working in four continents before joining the Gates Foundation in 2012. Samuel graduated from the faculty of Veterinary Medicine and Animal Sciences of the University of Peradeniya, Sri Lanka. Gained his PhD in veterinary virology from the University of Hertfordshire for his research on foot-and-mouth disease virus at the Pirbright Institute and holds an MBA from the University of Oxford. He is a Fellow of the Royal Society of Biology.
Director of Livestock and Aquaculture within the Agriculture Development Program, Bill & Melinda Gates Foundation
Natalie Ahlborn
Natalie's role is to inform the SNi from a nutritional perspective. She also supports the team by representing SNi's work through speaking engagements and other outputs.
Postdoctoral Research Fellow
Patricia Soh
Prior to her current PhD, Patricia attained a Master of Science in Human Nutrition at Massey University, Albany. The current focus of her PhD is investigating nutritional concerns within vegan diets.
PhD Student
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